National Provider Identifier [NPI]: |
1720376684 |
Last Name Of The Provider |
HOUT |
First Name Of The Provider |
BRITTANY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
670 W ACADEMY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
RANDLEMAN |
Zip Code Of The Provider |
273179748 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
306 |
Number Of Medicare Beneficiaries |
80 |
Total Submitted Charge Amount |
23449 |
Total Medicare Allowed Amount |
13728.92 |
Total Medicare Payment Amount |
10920.55 |
Total Medicare Standardized Payment Amount |
13103.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
1036 |
Total Drug Medicare AllowedAmount |
449.24 |
Total Drug Medicare PaymentAmount |
433.38 |
Total Drug Medicare Standardized Payment Amount |
433.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
265 |
Number Of Medicare Beneficiaries With Medical Services |
80 |
Total Medical Submitted Charge Amount |
22413 |
Total Medical Medicare Allowed Amount |
13279.68 |
Total Medical Medicare Payment Amount |
10487.17 |
Total Medical Medicare Standardized Payment Amount |
12670.38 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
25 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
30 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
28 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1153 |